目的探讨TACE(transcatheter arterial chemoeblization)序贯联合CT导向下RFA(radiofrequency ablation)及CIK(cytokine induced killer cells)细胞经肝动脉灌注治疗原发性肝癌(primary hepatocellular carcinoma,HHC)的护理。方法57例...目的探讨TACE(transcatheter arterial chemoeblization)序贯联合CT导向下RFA(radiofrequency ablation)及CIK(cytokine induced killer cells)细胞经肝动脉灌注治疗原发性肝癌(primary hepatocellular carcinoma,HHC)的护理。方法57例HCC经TACE序贯联合RFA治疗后1～3周,联合C I K治疗,首先连续完成4次C I K细胞经肝动脉回输,每次间隔时间为1～3周;再每4周1次,共行4次C I K细胞经肝动脉回输,每次回输CIK的数量为1.1×1010～1.5×1010。在这过程中,做好患者的心理护理,严格无菌操作,在T A C E、R F A和CIK治疗时严密观察不良反应和并发症,及时采取相应的措施和护理。1.心理护理:详细讲解治疗的目的、方法、必要性、安全性以及可能发生的并发症,使患者解除顾虑,以良好的心态接受治疗;2.T A C E后的护理:观察穿刺点情况和化疗栓塞后的反应;3.R F A后护理:注意穿刺点周围皮肤的变化,观察疼痛的状况;4.C I K采取和回输后的护理:采血时严格无菌操作,培养液要在30分钟内输完。结果57例患者经有效的心理护理,消除了顾虑,均顺利完成了整个过程。大部分患者有轻微的消化道反应,无须作特殊处理;10例患者有发热,体温37.5～39.5之间,部分高热患者需用退热药。结论T A C E序贯联合R F A治疗和抗肿瘤效应细胞(C I K)是治疗原发性肝癌的一种新模式,它提高了原发性肝癌无瘤生存期并明显降低乙肝病毒体内含量或消除乙肝病毒,阻断致癌因素;而且安全性好,副作用少,能提高患者的生活质量。展开更多
AIM: Cytotoxic T lymphocytes (CTLs) play an important role in resolving HBV infection. In the present study, we attempted to evaluate the efficiency of bone marrow-derived dendritic cells (DCs) transduced with recombi...AIM: Cytotoxic T lymphocytes (CTLs) play an important role in resolving HBV infection. In the present study, we attempted to evaluate the efficiency of bone marrow-derived dendritic cells (DCs) transduced with recombinant retroviral vector bearing hepatitis B virus (HBV) core gene and the capability of generating CTLs against HBcAg by genetically modified DCs in vivo.METHODS: A retroviral vector containing HBV core gene was constructed. Replicating DC progenitor of C57BL/6 mice was transduced by retroviral vector and continually cultured in the presence of recombinant mouse granulocytemacrophage colony-stimulating factor (rmGM-CSF) and interleukin-4(IL-4) for 6 days. LPS was added and cultured for additional two days. The efficiency of gene transfer was determined by PCR, Western blot and FACS. Transduced DCs immunized C57BL/6 mice subcutaneously 2 times at an oneweek interval. Intracellular IFN-γ and IL-4 of immunized mice lymphocytes were analyzed. Generation of CTLs in lymphooytes stimulated with mitomycin C-treated EL4-C cell which stably expresses HBcAg was determined by LDH release assays.RESULTS: Recombinant retroviral expression vector (pLCSN) was positively detected by PCR as well as enzyme digestion with EcoRI and BamH I. Retroviruses were generated by pLCSN transfection packing cell and the virus titer was 3x10s CFU/ml. Indirect immunofluorescence and FACS showed that HBV core gene was expressed in murine fibroblasts. Transduced bone marrow cells had capability of differentiating into DCsc in vitro in the presence of rmGMCSF and rmIL-4. The result of PCR showed that HBV core gene was integrated into the genome of transduced DCs.Western blot analysis showed that HBV core gene was expressed in DCs. The transduction rate was 28 % determined by FACS. Retroviral transduction had no influence on DCs expressions of CD80 and MHC class Ⅱ. HBcAg specific CTLs and Th1 type immune responses could be generated in the mice by using transduced DCs as antigen presenting cells (APCs).CONCLUSION: Retroviral transduct展开更多
文摘目的探讨TACE(transcatheter arterial chemoeblization)序贯联合CT导向下RFA(radiofrequency ablation)及CIK(cytokine induced killer cells)细胞经肝动脉灌注治疗原发性肝癌(primary hepatocellular carcinoma,HHC)的护理。方法57例HCC经TACE序贯联合RFA治疗后1～3周,联合C I K治疗,首先连续完成4次C I K细胞经肝动脉回输,每次间隔时间为1～3周;再每4周1次,共行4次C I K细胞经肝动脉回输,每次回输CIK的数量为1.1×1010～1.5×1010。在这过程中,做好患者的心理护理,严格无菌操作,在T A C E、R F A和CIK治疗时严密观察不良反应和并发症,及时采取相应的措施和护理。1.心理护理:详细讲解治疗的目的、方法、必要性、安全性以及可能发生的并发症,使患者解除顾虑,以良好的心态接受治疗;2.T A C E后的护理:观察穿刺点情况和化疗栓塞后的反应;3.R F A后护理:注意穿刺点周围皮肤的变化,观察疼痛的状况;4.C I K采取和回输后的护理:采血时严格无菌操作,培养液要在30分钟内输完。结果57例患者经有效的心理护理,消除了顾虑,均顺利完成了整个过程。大部分患者有轻微的消化道反应,无须作特殊处理;10例患者有发热,体温37.5～39.5之间,部分高热患者需用退热药。结论T A C E序贯联合R F A治疗和抗肿瘤效应细胞(C I K)是治疗原发性肝癌的一种新模式,它提高了原发性肝癌无瘤生存期并明显降低乙肝病毒体内含量或消除乙肝病毒,阻断致癌因素;而且安全性好,副作用少,能提高患者的生活质量。
基金a grant from Key Lab Programs of Jiangsu Province,No.k2030
文摘AIM: Cytotoxic T lymphocytes (CTLs) play an important role in resolving HBV infection. In the present study, we attempted to evaluate the efficiency of bone marrow-derived dendritic cells (DCs) transduced with recombinant retroviral vector bearing hepatitis B virus (HBV) core gene and the capability of generating CTLs against HBcAg by genetically modified DCs in vivo.METHODS: A retroviral vector containing HBV core gene was constructed. Replicating DC progenitor of C57BL/6 mice was transduced by retroviral vector and continually cultured in the presence of recombinant mouse granulocytemacrophage colony-stimulating factor (rmGM-CSF) and interleukin-4(IL-4) for 6 days. LPS was added and cultured for additional two days. The efficiency of gene transfer was determined by PCR, Western blot and FACS. Transduced DCs immunized C57BL/6 mice subcutaneously 2 times at an oneweek interval. Intracellular IFN-γ and IL-4 of immunized mice lymphocytes were analyzed. Generation of CTLs in lymphooytes stimulated with mitomycin C-treated EL4-C cell which stably expresses HBcAg was determined by LDH release assays.RESULTS: Recombinant retroviral expression vector (pLCSN) was positively detected by PCR as well as enzyme digestion with EcoRI and BamH I. Retroviruses were generated by pLCSN transfection packing cell and the virus titer was 3x10s CFU/ml. Indirect immunofluorescence and FACS showed that HBV core gene was expressed in murine fibroblasts. Transduced bone marrow cells had capability of differentiating into DCsc in vitro in the presence of rmGMCSF and rmIL-4. The result of PCR showed that HBV core gene was integrated into the genome of transduced DCs.Western blot analysis showed that HBV core gene was expressed in DCs. The transduction rate was 28 % determined by FACS. Retroviral transduction had no influence on DCs expressions of CD80 and MHC class Ⅱ. HBcAg specific CTLs and Th1 type immune responses could be generated in the mice by using transduced DCs as antigen presenting cells (APCs).CONCLUSION: Retroviral transduct
